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Pressure, Heat, and Cold Help Relieve Headache Pain
The effectiveness of extracranial pressure coupled with heat or cold to treat headaches is supported by anecdotal and scientific evidence. Some patients report standing under a hot shower and using a towel as a tourniquet to apply extracranial pressure. According to the literature, ancient Egyptians used these techniques for pain relief.1 Recent studies have attempted to quantify the effectiveness of individual treatments.2-4 While this beneficial treatment has been used throughout time and is recognized by the scientific community as effective, a more efficient method of administering a combined treatment is needed. This study was conducted to assess the effectiveness of a headband for the combined application of pressure, heat, and cold for headache relief.
Methods
Fifteen typical headache clinic patients participated in the study and used a headband designed to produce pressure by pulling a tension strap through a restraint slide and securing it by a hook and loop fastener (Figure 1). Heat or cold was provided by microwaved or frozen gel-packs inserted into zippered pockets. All patients fulfilled International Headache Society classification criteria5 for their headache types and were unable to achieve optimal relief with medication. Ten patients (7 women, 3 men) with moderate to severe migraines and 5 patients (2 women, 3 men) with episodic tension headaches were given headbands and diaries. The patients reported their typical headache durations when using medication without the headbands. Patients were instructed to maintain their medication regimens and to use the headbands at their discretion for the next 3 respective headaches. For each headache, the patient recorded in the diary the duration of headband use, the use of pressure, heat, and cold, and the resulting degree of relief on a scale of 0 to 3 (0 = not effective, 1 = minimally effective, 2 = moderately effective, and 3 = optimally effective).
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Headband integrates pressure, heat, and cold. 1 Indicates gel-packs; 2, mesh inner layer; 3, zipper; 4, nylon outer layer; 5, foam insulation; 6, nylon liner; 7, grab tab; 8, restraint slide; 9, tension strap; 10, hook and loop fastener; and 11, elastic band.
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Results
All patients (mean age, 36.8 years [age range, 8-51]) completed the study. Eighty-seven percent (P = .004) rated the effectiveness of the device in relieving their headaches as "optimally effective," and 13% rated it as "moderately effective." All patients preferred pressure, but the use of heat or cold varied. Those who had migraines found heat and cold to be equally effective (heat, 15 of 30 treatments; cold, 15 of 30 treatments). Those with tension headaches preferred pressure with cold (13 of 15 treatments), but the difference was not statistically significant. The duration of headaches while using the headband ranged from 0.67 to 2.83 hours, and the duration of headaches without the headband but with medication ranged from 2 to 8 hours.
Comment
Results from this study demonstrate that simultaneous pressure, heat, and cold help relieve headache and reduce headache duration. This treatment is administered by the patient and can be tailored to individual preferences for temperature and pressure. The effectiveness of medication for headaches depends on the patient but frequently is suboptimal. The headband offers a pain relief option that does not carry the risks and concerns inherent in the use of medication.
AUTHOR INFORMATION
We thank Casey Laizure, PharmD, Jim Wan, PhD, and Judy McGinnis, RN, CCRC, for their assistance.
Stephen H. Landy, MD
Wesley Headache Clinic
7655 Poplar Ave, Suite 385
Memphis, TN 38138
Brand Griffin, MD
Huntsville, Ala
1. Edmeads J. The treatment of headache: a historical perspective. In: Gallagher RM, ed. Drug Therapy for Headache. New York, NY: Marcel Dekker Inc; 1990:1-8.
2. Lance JW. The controlled application of cold and heat by a new device (migra-lief apparatus) in the treatment of headache. Headache. 1988;28:458-461.
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3. Robbins LD. Cryotherapy for headache. Headache. 1989;29:598-600.
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4. Vijayan N. Head band for migraine headache relief. Headache. 1993;33:40-42.
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5. Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias, and facial pain. Cephalalgia. 1988;8(suppl 7):1-96.
Arch Fam Med. 2000;9:792-793.
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